December 2015
www.groupmarketingservices.com
Great Lakes
Employers
Association
Group Marketing
Services, Inc.
Michigan House Bill 5014: Health Insurance Claims Assessment Tax
A PUBLICATION FROM GROUP MARKETING SERVICES, INC. KALAMAZOO – GRAND RAPIDS – (800) 354-4768
The Michigan Health Insurance Claims Assessment
(HICA) Tax Is Costing Your Business $ Every Month.
Tell Your State Representative and Senator: This is Bad
Public Policy… Tell them to Oppose It!
The Michigan Health Insurance Claims Assessment (HICA)
took effect in January 2012. The HICA was originally a tax
of 1% on all medical, vision and dental claims paid for
services performed by a Michigan provider to a
Michigan resident. The revenue from the tax was
purportedly to be used to fund the expansion of
Medicaid which Governor Rick Snyder signed
into law on September 16, 2013 (Authorized
by Section 2001 of the Affordable Care Act).
The HICA tax, when passed, was scheduled
to sunset on December 31, 2014. We wrote to
you in June 2014 announcing that the Michigan Health Insurance Claims Assessment was
reduced, and the tax was now being extended thru 2017.
The original defense and passing of this
"movement tax" was that the ACA would not allow
the State to continue to tax HMO's doing Medicaid business.
New York and California are still taxing HMO's. No change.
Michigan legislature elected to expand Medicaid with the implementation of the Affordable Care Act (Obama Care) and
now tax Employers funding benefits.
Nothing has changed with this “temporary” tax, except now
Governor Snyder wants to repeal the Sunset Provision, raise
the tax rate, remove the $400,000,000 cap and make this
Health Insurance Claims Assessment Tax PERMANENT,
using it as part of his recently submitted proposed budget.
In this Issue...
The Employer is being assessed a special tax because they are
providing Medical, Surgical, Hospital, Dental and Prescription Benefits to their employees.
When the employees or their families visit a health care
provider/use the benefits, the State of Michigan is collecting
a TAX from the Employer on the paid claim. Just like
adding a Sales Tax without a ballot vote.
Now Gov. Snyder wants to raise the tax rate, remove
the cap and make this temporary tax PERMANENT.
The State (Lansing) Legislature may go along with it.
Scary. Tell them They SHOULD NOT!
UPDATE: December, 2015 the bill to amend 2011 PA
142, entitled "Health Insurance Claims Assessment
Act”, was unanimously voted out of committee and
sent to the floor for scheduling. (Bill will go to the Senate
next). For the latest updates on House Bill #5014, visit:
http://www.legislature.mi.gov/.
The Michigan Chamber of Commerce is calling it “a $2.3
billion tax increase.” The bill would "renege" on tax refunds
in 2016 and 2017, which amounts to $47 million in promised
rebates that won't be realized.”
We urge all Michigan employers to contact your State Representatives and voice your opposition to the Health
Insurance Claims Assessment Tax and the added expense it
poses to your business. Who is my State Representative ?
Visit: http://gophouse.org/representatives/westmi/
Who is my State Senator ?
Visit: http://www.senate.michigan.gov/fysbyaddress.html
ACTION IS REQUIRED IMMEDIATELY. Time is of the
essence... Have your voice heard!
• Affordable Care Act (ACA)
• Many Disorders Share Symptoms with
Michigan Excise Tax ...................................... Page 1
Multiple Sclerosis ............................................ Page 3
• Influenza (Flu) Shot Benefit Now Part of Your
• Flexible Spending Account (FSA) ..................... Page 3
GLEA Group Insurance Plan ........................... Page 1, 2 • Year-End Reminder From SSA ......................... Page 4
• GLEA Progressive Dental Plan Benefits ........ Page 2
• GMS Keeps Employers Informed ...................... Page 4
• ACA Automatic Enrollment Mandate Repealed Page 4
• Ask Nurse Jen .................................................. Page 4
Merry
Christmas!
For more information,
please contact:
Group Marketing
Services, Inc.
(800) 632-5015
Influenza (Flu) Shot Benefit Now Part of Your GLEA Group Insurance Plan
more information, contact 1 (800) 632-5015, ext. 109.
August 1, 2015, through April 30, 2016, you can obtain your
Injectable Seasonal Influenza Vaccine (flu shot) with your
group health insurance ID Card through the Group Marketing Services, Inc. Prescription Drug Card Program.
There are two flu vaccine types:
1. Trivalent: The traditional flu vaccines made to protect
against three common flu viruses.
2. Quadrivalent: The new vaccines made to
protect against four different flu viruses.
Additional Non-Seasonal Vaccines now eligible under the
GLEA Prescription Drug Card Program with a $ -0- Copay,
No Cost to our Insureds at the Participating In-Network
Pharmacies, including:
These two types have four options:
1. Intramuscular: Traditional shot into the muscle.
2. Intradermal: Injection into the skin rather than the muscle.
3. Intranasal: Inhaled spray into the nose.
4. High Dosage: Higher dosage of the vaccine.
The GLEA Employer-Sponsored Group Prescription Drug
Card Program covers the traditional Intramuscular, Trivalent, standard dose flu vaccine and High Dosage, Quadrivalent , Intradermal or Intranasal flu vaccines.
1) Preventive Care Vaccines for Adults:
a) Pneumonia
b) Zoster (Zostavax)
c) Tetanus, Diptheria Toxoids
d) Hepatitis A & B.
2) Preventive Care Vaccines for
Children (birth to age 18):
a) Pneumonia
b) Haemophilus B
c) Haemophilus B, Hepatitis B
d) Meningiococcal,
Haemophilus B, Tetanus
e) Inactivated Poliovirus
f) Rotavirus
g) Measles, Mumps, Rubella, Varicella
h) Diptheria, Tetanus.
Some common covered vaccines are Afluria, Fluarix, Flucelvax, Fluvirin and Fluzone. These are
all Trivalent Intramuscular vaccines made by
several different manufacturers.
Please Note: It is important the pharmacy follows the Caremark screen message when accessing your benefits. Pharmacists needing assistance
should call 1-800-345-5413.
You may want to advise the pharmacy to direct a copy of the
immunization you receive to your Primary Care Physician to
add to your permanent medical records.
This is a benefit with $0 Copay and only available at any of
the In-Network Caremark Prescription Drug Card Participating Pharmacies, where you choose to fill your prescriptions if
they also provide injections by the registered pharmacist. For
•Progressive
Dental Plan
The GLEA Progressive Dental Plan is targeted to reward the permanent employee.
Dental benefit increases in your plan occur each January 1st, following the
individual’s effective date.
Benefit Schedule
Individual Calendar Year
Maximum Benefit Payable
Calendar Year Deductible Per Person
Preventative
Routine
Major
Orthodontia (children under 19 only, lifetime max. $750)
Maximum Deductible Per Person
Plan Pays the following Percentage*
PREVENTATIVE PROCEDURES
ROUTINE PROCEDURES
MAJOR PROCEDURES
ORTHODONTIA PROCEDURES
1ST
CALENDAR
YEAR
2ND
$ 800
$ 1,000
NONE
$ 50
N/A
N/A
$ 50
NONE
$ 50
**$ 50
**NONE
$ 50
75%
60%
NONE
NONE
85%
75%
** 50%
**50%
3RD
EACH
YEAR
THEREAFTER
NONE
$ 25
$ 25
NONE
$ 25
NONE
$ 25
$ 25
NONE
$ 25
100%
80%
50%
50%
100%
80%
50%
50%
$ 1,250
*of dentist’s charges or amount shown in Schedule of Maximum Allowances, whichever is the lesser.
$1,500
**no benefits payable under Major or Orthodontia until completion of 12 months coverage following the individual’s certificate
effective date. Likewise, no expenses for Major or Orthodontic procedures apply to any calendar year’s deductible until
completion of 12 months coverage following the person’s certificate effective date.
1) There is no transfer of benefits available. Expenses prior to the effective date do not credit towards the deductible.
2) The change in calendar year Benefit Schedule is the first of January following the effective date.
3) If the Employer group’s Progressive Dental Plan is effective in 2015, the 2nd year Benefits start on January 1st 2016.
4) This program benefits the long-term employee and provides the employer a more efficient blended premium rate.
2
Many Disorders Share Symptoms with Multiple Sclerosis
Many autoimmune and inflammatory disorders share
symptoms with multiple sclerosis, requiring doctors to rule
out these conditions to accurately diagnose MS.
overlap. Sjogren’s causes fatigue and musculoskeletal pain
and is more prevalent in women. The telltale signs are dry
eyes and dry mouth, which makes it different from MS.
Vasculitis. This inflammatory disorder can mimic MS, says
Kathleen Costello, MS, associate vice president of the Clinical
Care Advocacy, Services and Research Department of the
National Multiple Sclerosis Society. Vasculitis can affect your
joints and cause joint pain. When it affects your eyes, you
can have blurred vision. When it affects nerves, you can
have numbness, tingling, and weakness in limbs.
By Beth W. Orenstein, Reviewed by Farrokh Sohrabi, MD
Getting the correct diagnosis of multiple sclerosis (MS) can be a
challenge. For starters, no
single test can determine a diagnosis conclusively. But there’s
more: Not everyone
has all of the common symptoms of
MS– numbness, tingling, pain, fatigue, and
heat sensitivity– and the
ones you do have can be symptoms
of a condition commonly mistaken for MS.
Myasthenia gravis. (Amyotrophic Lateral Sclerosis
[ALS] or Lou Gehrig's disease). Myasthenia gravis
causes muscle weakness that, like in MS, often appears
gradually over months to a year or two. It also causes
double vision and difficulty walking and swallowing.
The difference is that MS is an autoimmune disorder of
the central nervous system, whereas myasthenia gravis is a
disorder of the skeletal muscles.
Sarcoidosis. Sarcoidosis is another disorder that may share
some neurological symptoms with MS: decreased vision,
numbness, muscle weakness, and bowel and bladder
changes. Though sarcoidosis can affect the brain, it usually
starts in the lungs.
Here are conditions that can be mistaken for MS, starting
with the most common:
Lupus. Like MS, lupus is an autoimmune disorder affecting
more women than men that can cause muscle pain, swelling
of joints, fatigue, and migraines. “Lupus can begin just like
MS,” Dr. Burks of MSA of America says. People with lupus
don’t always have its typical rash and arthritis right away,
making symptoms seem even more like MS.
Vitamin B12 deficiency. Vitamin B12 plays a role in the metabolism of fatty acids needed to maintain the myelin sheath,
the protective covering of the nerve fibers in the brain and
spinal cord. When you’re deficient in B12, you can have MSlike symptoms such as fatigue, memory loss, and even depression. Vitamin B12 deficiency can be identified with a
simple blood test.
Lyme disease. Lyme disease is an infection of the central
nervous system transmitted through a tick bite. Symptoms
include fatigue, headache, and muscle and joint aches – just
like MS. If you live in an area known for Lyme disease or recently traveled to one, your doctor will want to rule out the
possibility. It is important to treat early.
Acute disseminated encephalomyelitis (ADEM). This is a
severe inflammatory attack affecting the brain and spinal
cord. The symptoms are similar to MS, with fatigue,
headache, nausea, vomiting, vision loss, and difficulty walking. A very rare condition, ADEM typically comes on rapidly,
often after a viral or bacterial infection. Children are more
likely to have ADEM, while MS is more likely to occur in
adults.
MS Living Tips: www.ms-pill.com Learn about the MS Community and the support services available.
Stroke. Stroke and MS are both diseases of the brain. Symptoms of an MS flare can be similar to a stroke: loss of vision, difficulty walking, loss of feeling in limbs
usually on one side of the body, and difficulty
speaking. “While MS can occur in 70 year
olds, if the person is older, you tend to
think of stroke, not MS.” A stroke requires urgent attention– if you think
you’re experiencing a stroke, call 911 immediately.
RELATED: Is it Multiple Sclerosis or something else?
Rare MS mimics include:
• Human T-cell lymphotropic virus-1, which can
cause progressive spinal cord dysfunction;
• Migraines;
• Behcet’s disease, an inflammation of blood vessels
throughout the body;
• Neurosyphilis, the advanced form of syphilis;
• Dural arteriovenous fistulas, abnormal structures
of blood vessels along the spinal cord;
• Binswanger’s disease, a type of vascular dementia.
Fibromyalgia. Fibromyalgia and MS have
some similar symptoms, including headache,
joint and muscle pain, numbness and tingling of
extremities, and fatigue. Like MS, fibromyalgia
also affects women more often than men. But unlike MS, fibromyalgia will not show up on an MRI.
Sjogren’s syndrome. Sjogren’s is another autoimmune disorder, and the symptoms of many autoimmune disorders can
If you experience symptoms of any of these
disorders, see a neurologist. Only with a
correct diagnosis can you receive
appropriate treatment.
For the taxable year beginning in 2016, the dollar limitation
under IRS Code Sec 125(i) on voluntary employee wage re-
ductions for annual contributions to health flexible spending
account/arrangements is unchanged from 2015, at $2,550.
Flexible Spending Accounts (FSA)
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Year-End Reminder From The Social Security Administration
www.socialsecurity.gov/signin
and sign into your account.
We’d like to remind you to review your Social Security Statement online. The Statement has important Social Security information and, if applicable, estimates of your future benefits.
With instant access to your Social
Security Statement at any time,
you will no longer receive one
periodically in the mail, saving
money and the environment.
If you are working, we encourage you to check your Statement yearly to make sure your earnings record is correct. The
Statement also will help in planning your financial future.
To view your most recent Statement, please visit:
Keeping Employers with Disability Insurance Informed
Group Marketing Services, Inc. sends a report to the Employers each week whose Employees have received disability insurance paid benefits for that week.
A letter is sent along with the reports notifying Employers
of their responsibility for itemizing on the Quarterly State Tax
Form 941 reporting taxes/wages as well as adding disability
insurance benefits paid to the employee's year-end W-2 form.
At the end of each month, quarterly and at year end, benefit
payment reports are sent to those Employers, detailing benefits
paid during the current month, quarter and year respectively.
Federal Budget Bill Repeals ACA Automatic Enrollment Mandate
Deal also includes provisions that impact single-employer pension
premiums.
employer’s health benefits plans, and continue the enrollment of current employees in a health benefits plan offered
through the employer.
On November 2, 2015 President Barack Obama signed the Bipartisan Budget Act of 2015 (H.R. 1314) into law. The bill may
impact certain employers because it repeals a section of the
Affordable Care Act (ACA) and increases the premiums paid
to the Pension Benefits Guaranty Corporation (PBGC).
The bill also changes payments to single-employer pension
plans. The changes, according to a report by the Society for
Human Resource Management (SHRM) include:
• Flat-rate premiums increasing by 22 percent from 2016 levels.
• Variable rates increasing by 24 percent from 2016 levels.
• Annual due date for the 2025 premiums is now September
15, instead of October 15.
The repealed section of the ACA is the automatic enrollment
mandate (was due to start in 2016), which stated that any employer that has more than 200 full-time employees must automatically enroll new full-time employees in one of the
Ask Jen
include whole wheat foods, fruits, vegetables and beans. Low
fiber simple sugars are potatoes, chips, white bread and pasta.
I have heard that cutting carbohydrates (carbs) makes you
lose weight...
(Jennifer, N.A.S.M.) A: You should try not to consume less
than 1200 calories a day. Try to get as many of those 1200 calories from your proteins first. This helps maximize your metabolic rate for weight loss regime, the body's fat-burning friend.
Q: What carbs should I avoid?
Does my body need carbs?
What should I eat?
(Jen, R.N.) A: These are
common questions. In the
end, weight loss occurs by
reducing your intake of
calories. Your body needs
carbohydrates. Ideally
high fiber complex carbohydrates, 5 or more grams
of fiber per serving is considered high fiber. Women should get 25 gm. of fiber a day
and men 30-38 gms. a day. When following a
low carbohydrate diet, avoid the simple
carbohydrate foods that are low in fiber
like 1gm of fiber per serving. The high
fiber carbs pull the sugar or glucose
out of the digestive system and the
fiber is not broken down into sugar,
this actually aids in weight loss. If a
serving of food has 5 or more grams
of fiber you can subtract the 5 from the
total grams of carbohydrates. Complex carbs
GMS NEWS 2015 VOL.4 HR_12-15
FACT: The body burns more calories maintaining muscle
than it does maintaining fat. This means the more muscle
you build, the more calories your body will naturally burn.
Feed the muscle so it can burn the fat. The body burns more
calories processing protein than it burns to process carbs and
fat. This is known as the thermic effect of food.
Your body burns carbs (including stored carbs) before it
burns fat. If you bring down your daily carb-count intake
the body will then start burning the (adipose tissue/fat)
storage. This is why the low carb
diet is successful.
Do you have a question?
Ask Jen, R.N. – or – Jennifer, N.A.S.M.
at Group Marketing Services, Inc.
Toll Free: (800) 354-4768
www.groupmarketingservices.com
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